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Effects of the COVID-19 pandemic on secondary care for cardiovascular disease in the UK: an electronic health record analysis across three countries
European Heart Journal - Quality of Care and Clinical Outcomes, Volume: 9, Issue: 4
Swansea University Author: Ashley Akbari
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© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited.Download (1.29MB)
BackgroundAlthough morbidity and mortality from COVID-19 have been widely reported, the indirect effects of the pandemic beyond 2020 on other major diseases and health service activity have not been well described.Methods and resultsAnalyses used national administrative electronic hospital records i...
|Published in:||European Heart Journal - Quality of Care and Clinical Outcomes|
Oxford University Press (OUP)
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BackgroundAlthough morbidity and mortality from COVID-19 have been widely reported, the indirect effects of the pandemic beyond 2020 on other major diseases and health service activity have not been well described.Methods and resultsAnalyses used national administrative electronic hospital records in England, Scotland, and Wales for 2016–21. Admissions and procedures during the pandemic (2020–21) related to six major cardiovascular conditions [acute coronary syndrome (ACS), heart failure (HF), stroke/transient ischaemic attack (TIA), peripheral arterial disease (PAD), aortic aneurysm (AA), and venous thromboembolism(VTE)] were compared with the annual average in the pre-pandemic period (2016–19). Differences were assessed by time period and urgency of care.In 2020, there were 31 064 (−6%) fewer hospital admissions [14 506 (−4%) fewer emergencies, 16 560 (−23%) fewer elective admissions] compared with 2016–19 for the six major cardiovascular diseases (CVDs) combined. The proportional reduction in admissions was similar in all three countries. Overall, hospital admissions returned to pre-pandemic levels in 2021. Elective admissions remained substantially below expected levels for almost all conditions in all three countries [−10 996 (−15%) fewer admissions]. However, these reductions were offset by higher than expected total emergency admissions [+25 878 (+6%) higher admissions], notably for HF and stroke in England, and for VTE in all three countries. Analyses for procedures showed similar temporal variations to admissions.ConclusionThe present study highlights increasing emergency cardiovascular admissions during the pandemic, in the context of a substantial and sustained reduction in elective admissions and procedures. This is likely to increase further the demands on cardiovascular services over the coming years.
Faculty of Medicine, Health and Life Sciences
The British Heart Foundation Data Science Centre (grant No
SP/19/3/34 678, awarded to Health Data Research (HDR) UK) funded
co-development (with NHS Digital) of the TRE, provision of linked
datasets, data access, user software licences, computational usage,
and data management and wrangling support with additional contributions from the HDR UK Data and Connectivity component of
the UK Government Chief Scientific Adviser’s National Core Studies
programme to coordinate national covid-19 priority research. Consortium partner organisations funded the time of contributing data
analysts, biostatisticians, epidemiologists, and clinicians. This work was
supported by the Con-COV team funded by the Medical Research
Council (grant number: MR/V028367/1).
This work was supported by Health Data Research UK, which
receives its funding from HDR UK Ltd (HDR-9006) funded by the UK
Medical Research Council, Engineering and Physical Sciences Research
Council, Economic and Social Research Council, Department of
Health and Social Care (England), Chief Scientist Office of the Scottish
Government Health and Social Care Directorates, Health and Social
Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF)
and the Wellcome Trust.
This work was supported by the ADR Wales programme of work,
aligned to the priority themes 410 as identified in the Welsh Government’s national strategy: Prosperity for All. ADR Wales brings
together data science experts at Swansea University Medical School,
staff from the Wales Institute of Social and Economic Research,
Data and Methods (WISERD) at Cardiff University and specialist teams within the Welsh Government to develop new evidence which
supports Prosperity for All by using the SAIL Databank at Swansea
University, to link and analyse anonymised data. ADR Wales is part
of the Economic and Social Research Council (part of UK Research
and Innovation) funded ADR UK (grant ES/S007393/1). This work
was supported by the Wales COVID-19 Evidence Centre, funded by
Health and Care Research Wales.